A systematic review of interventions on body image and disordered eating outcomes among women in midlife

Lewis-Smith, Helena; Diedrichs, Phillippa C.; Rumsey, Nichola; Harcourt, Diana

Abstract

© 2015 Wiley Periodicals, Inc. Objective Body dissatisfaction and disordered eating are widely recognized as issues that warrant attention among women in midlife, particularly the development and delivery of effective interventions. This article systematically reviews existing research on interventions among midlife women on body image and disordered eating outcomes, in order to inform intervention delivery and provide strategic directions for future research. Method Fourteen electronic databases were searched for articles published between 1992 and 2015 that evaluated interventions with nonclinical samples of women (M age 35-55 years) in controlled trials with at least one body image measure. Data were extracted and evaluated, and the methodological quality of studies was assessed using the Cochrane Collaboration tool for assessing risk of bias. Results From 7,475 records identified, nine articles evaluating 11 interventions met the inclusion criteria. Seven interventions significantly improved body image at post-test (d's = 0.19-2.22), with significant improvements on disordered eating achieved by two of these interventions (d's = 0.90-1.72). Sustained improvements were achieved by three interventions that employed a multisession, therapeutically based, group intervention format; two with sustained body image and disordered eating improvements, and one with sustained body image improvements only (d's = 0.55-1.21; 2 weeks to 6 months). Methodological quality varied between studies. Discussion To date, three interventions have demonstrated sustained improvements and are indicated for practitioners aiming to improve body image and disordered eating among women in midlife. Replication and more rigorous randomised controlled trials are required to enhance the methodological quality of intervention studies in this field. Resumen Objetivo La insatisfacciõn corporal y la alimentaciõn desordenada son ampliamente reconocidas como dos cuestiones que requieren atenciõn entre las mujeres de la mediana edad, particularmente el desarrollo y aplicaciõn de intervenciones efectivas. Este artículo revisa sistemáticamente la investigaciõn existente de intervenciones entre mujeres de la mediana edad en imagen corporal y resultados de alimentaciõn desordenada, con la intenciõn de informar de la aplicaciõn de la intervenciõn y proveer de directrices estratégicas para la investigaciõn futura. Método Se buscaron artículos publicados entre 1992-2015 en catorce bases de datos electrõnicas que evaluaron intervenciones con muestras no-clínicas de mujeres (Edad promedio de 35-55 años) en estudios controlados con al menos una medida de la imagen corporal. Los datos fueron extraídos y evaluados, y la calidad metodolõgica de los estudios fue evaluada utilizando la herramienta de Cochrane Collaboration para evaluar el riesgo de sesgo. Resultados De 7,475 archivos identificados, 9 artículos evaluando 11 intervenciones cumplieron con los criterios de inclusiõn. Siete intervenciones mejoraron significativamente la imagen corporal en las post-pruebas (ds=0.19-2.22), con mejorías significativas en la alimentaciõn desordenada alcanzadas por dos de estas intervenciones (ds=0.90-1.72). Las mejorías sostenidas se alcanzaron por tres de las intervenciones que utilizaron un formato de intervenciõn en grupo, basado en terapia, multi-sesiones; dos con mejorías sostenidas en imagen corporal y alimentaciõn desordenada, y una con mejoría sostenida en imagen corporal solamente (ds= 0.55-1.21; 2 semanas - 6 meses). La calidad metodolõgica variõ entre los estudios. Discusiõn A la fecha, tres intervenciones han demostrado mejoría sostenida y están indicadas para los clínicos que desean mejorar la imagen corporal y alimentaciõn desordenada entre mujeres de la mediana edad. Se requiere una replicaciõn y estudios controlados aleatorios más rigurosos para mejorar la calidad metodolõgica de los estudios de intervenciõn en este campo.

• Journal Article Type: Review
• Acceptance Date: Oct 6, 2015
• Publication Date: Jan 1, 2016
• Deposit Date: Oct 20, 2015
• Publicly Available Date: Nov 26, 2016
• Journal: International Journal of Eating Disorders
• Print ISSN: 0276-3478
• Electronic ISSN: 1098-108X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 49
• Issue: 1
• Pages: 5-18
• DOI: https://doi.org/10.1002/eat.22480
• Keywords: body image, eating disorders, midlife, women
• Public URL: https://uwe-repository.worktribe.com/output/839731
• Publisher URL: http://dx.doi.org/10.1002/eat.22480
• Additional Information: Additional Information : This is the peer reviewed version of the following article: Lewis-Smith, H., Diedrichs, P. C., Rumsey, N. and Harcourt, D. (2015) A systematic review of interventions on body image and disordered eating outcomes among women in midlife. International Journal of Eating Disorders, 49 (1). pp. 5-18, which has been published in final form at http://dx.doi.org/10.1002/eat.22480. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Aug 2, 2016